Tag: study

Upvote Story 9
Diabetes mellitus is a common co-existing disease in the critically ill. Diabetes mellitus may reduce the risk of acute respiratory distress syndrome (ARDS), but data from previous studies are conflicting. The objective of this study was to evaluate associations between pre-existing diabetes mellitus and ARDS in critically ill patients with acute hypoxemic respiratory failure (AHRF). In a large, global observational study of patients with AHRF,... Read More | Comment
Upvote Story 7
The safety of cuffed endotracheal tubes in the neonatal and critically ill pediatric population continues to be questioned due to the theoretical risk of acquired subglottic stenosis. The incidence of acquired subglottic stenosis in the high-risk mixed surgical and medical critically ill pediatric cohort using high-volume, low-pressure cuffed endotracheal tube policy has not yet been described. We report no single case of acquired subglottic stenosis... Read More | Comment
Upvote Story 6
Functional status and chronic health status are important baseline characteristics of critically ill patients. The assessment of frailty on admission to the intensive care unit (ICU) may provide objective, prognostic information on baseline health. To determine the impact of frailty on the outcome of critically ill patients, we performed a systematic review and meta-analysis comparing clinical outcomes in frail and non-frail patients admitted to ICU.... Read More | Comment
Upvote Story 6
In this study, antipsychotics were used to treat nearly half of all antipsychotic-naïve ICU patients and were prescribed at discharge to 24% of antipsychotic-treated patients. Treatment with an atypical antipsychotic greatly increased the odds of discharge with an antipsychotic prescription, a practice that should be examined carefully during medication reconciliation since these drugs carry “black box warnings” regarding long-term use. After excluding 18 patients due... Read More | Comment
Upvote Story 4
There is great variability in end-of-life care and the legal context may interfere with decisions on limitation of medical treatment. In Brazil, end-of-life care was initially regulated in 2006, but legal controversies still continue. Even though physicians do not need authorization from the Judiciary system to act, those controversies may cause uncertainty regarding seemingly competing professional duties (caring for patients’ best interests versus maintenance of... Read More | Comment
Upvote Story 11
Aged, critically ill surgical patients have greater organ dysfunction and incidence of adverse clinical outcomes after sepsis. Biomarker profiles suggest an immunophenotype of persistent immunosuppression and catabolism. Advanced age may necessitate novel therapeutic strategies to promote multisystem organ recovery and improve survival after sepsis. The cohort included 173 patients with severe sepsis (n = 93; 53.8%) or septic shock (n = 80; 46.2%), with a... Read More | Comment
Upvote Story 6
A biomarker test based on the presence of two proteins in the blood appears to be suitable for ruling out significant intracranial injuries in patients with a history of mild traumatic brain injury (TBI) without the need for a CT head scan, according to data presented at the annual meeting of the American College of Emergency Physicians. A biomarker suitable for ruling out significant brain... Read More | Comment
Upvote Story 17
Dr. Sam Parnia, Director of the AWARE Study (AWAreness during REsuscitation) and one of the world’s leading experts on the scientific study of death and near-death experiences (NDE), presents cutting-edge research from the front lines of critical care and resuscitation medicine while also shedding light on the ultimate mystery: What happens to human consciousness during and after death? Dr. Parnia reveals how some form of... Read More | Comment
Upvote Story 4
A novel drug is showing promise for helping improve cognition in patients with mild to moderate Alzheimer’s disease (AD), according to new topline results. A phase 3 trial of more than 800 patients showed that those who were randomly assigned to receive oral GV-971 (Green Valley Pharmaceutical Co, China) met the primary endpoint of significant change from baseline to week 36 on the 12-item cognitive... Read More | Comment
Upvote Story 6
Acute respiratory distress syndrome (ARDS) is a clinical entity that acutely affects the lung parenchyma, and is characterized by diffuse alveolar damage and increased pulmonary vascular permeability. Currently, computed tomography (CT) is commonly used for classifying and prognosticating ARDS. However, performing this examination in critically ill patients is complex, due to the need to transfer these patients to the CT room. Fortunately, new technologies have... Read More | Comment
Upvote Story 20
Nurse intuition doesn’t sound scientific, but it could play a key role in critical-care outcomes, according to a small study published in DovePress. The researchers conducted a descriptive phenomenological study, interviewing 12 nurses who had at least three years of work experience in critical care units. Due to the small size of the study, more research is needed, However, the results indicate that many nurses... Read More | Comment
Upvote Story 5
Patterns and Outcomes Associated With Timeliness of Initial Crystalloid Resuscitation in a Prospective Sepsis and Septic Shock Cohort. Crystalloid was initiated significantly later with comorbid heart failure and renal failure, with absence of fever or hypotension, and in inpatient-presenting sepsis. Earlier crystalloid initiation was associated with decreased mortality. Comorbidities and severity did not modify this effect. The primary exposure was crystalloid initiation within 30 minutes... Read More | Comment
Upvote Story 7
Proton pump inhibitors are not associated with an increased risk for Clostridium difficile infection in ICU patients, according to the results of a retrospective cohort study. PPI use was not associated with a significant increase in CDI risk among patients who did not receive antibiotics (aHR = 1.56; 95% CI, 0.72-3.35). However, PPI use was actually associated with a lower risk for CDI among patients... Read More | Comment
Upvote Story 5
Bedside procedures are exceedingly common. Data regarding the severity of procedural pain and strategies to mitigate it are important for the informed consent process and patient satisfaction. Overall, pain reported from common bedside procedures is low, but pain can be further reduced with the addition of lidocaine onto the skin surface to modulate pain perception. A total of 481 patients provided consent and were randomized... Read More | Comment
Upvote Story 4
Mobilization of critically ill children, many with central lines, endotracheal tubes, and other life-saving devices, is associated with potential risks and complications. Hence, concerns about safety often guide staff perceptions about PICU mobility. These complications may include, but are not limited to, hemodynamic instability, accidental tube or line dislodgement, falls, pain, and anxiety. However, multiple studies have reported that early mobilization of critically ill children... Read More | Comment
Upvote Story 7
Changes in lactate levels after ECMO implantation is an important tool to assess effective circulatory support and it is found superior to single lactate measurements as a prognostic sign of mortality in our study. Based on our results, an early insertion of ECMO before lactate gets high was suggested. Serial changes on lactate levels and calculation of its clearance may be superior to single lactate... Read More | Comment
Upvote Story 8
Severe traumatic brain injury is a clinically heterogeneous disease that can be accompanied by a range of neurologic impairment and a variety of injury patterns at presentation. This secondary analysis of prospectively collected data identifies several characteristics associated with outcome among children with severe traumatic brain injury. Future, larger trials are needed to better characterize phenotypes within this population. Baseline, clinical, and CT characteristics of... Read More | Comment
Upvote Story 5
These results underline the importance of delirium screening in stroke patients specifically during the night. Since even short delirious episodes are associated with more complications and increased disability, future studies are needed to find delirium prevention strategies. 309 patients were included. The overall prevalence of delirium was 10.7% (33 patients) mostly on the first and second hospital day. Duration of delirium on SU was in... Read More | Comment
Upvote Story 10
In this randomized, double-blind, placebo-controlled, dose-finding adaptive phase 2a/2b trial enrolling 301 adults, the optimal therapeutic dose of recombinant alkaline phosphatase was 1.6 mg/kg. Treatment with this dose for 3 days when added to standard care resulted in a median increase in endogenous creatinine clearance of 27.6 mL/min vs 14.7 mL/min for placebo in the first 7 days, a difference that was not statistically significant.... Read More | Comment
Upvote Story 6
New research presented at this year’s ESICM LIVES conference (the annual meeting of the European Society of Intensive Care Medicine) shows that in rich countries overall, mortality from sepsis has fallen by around a quarter in men since 1985, with a smaller reduction in women. While some countries (namely, Finland, Iceland, Ireland and New Zealand) have made progress, mortality rates continue to rise in others... Read More | Comment